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General NPI Number Information
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NPI Number | 1083832299
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Entity Type | Organization
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Legal Business Name | GUMERCINDP R. JOSE, M.D., INC.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1524 SUNSET BLVD SUITE D
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City | STEUBENVILLE
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State | OH
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Zip | 43952-1380
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Country | US
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Telephone | 740-282-9789
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Fax | 740-282-7101
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Provider Business Mailing Address
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Address Line | 1524 SUNSET BOULEVARD SUITE D
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City | STEUBENVILLE
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State | OH
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Zip | 43952
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Country | US
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Telephone | 740-282-9789
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Fax | 740-282-7101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUMERCINDO R JOSE
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Credential | M.D.
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Telephone | 740-282-9789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35035561
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License Number State | OH
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